Warning Signs Of Plummer-Vinson Syndrome
Plummer-Vinson syndrome is a rare condition most often diagnosed in middle-aged women. Also known as Paterson-Brown Kelly syndrome, it was first described in 1919 by doctors in Philadelphia. Scientists noted a large number of cases in Sweden in the early twentieth century before food there was routinely fortified with iron. Currently, the syndrome seems to be more common in India than in Western nations. On the Indian subcontinent, the condition is equally prevalent in men and women.
To assess patients for this condition, doctors will perform a physical examination. The exam will focus on signs of iron deficiency, and the doctor will assess the patient's skin for pallor. They will also examine the patient's nails to check for spoon-shaped indentations. The physician may need to listen to the patient's heart to complete an evaluation for tachycardia. Patients will need to have a full blood count performed, and doctors may sometimes recommend a barium swallow test to check for esophageal webs.
Painful And Difficult Swallowing
Painful and difficult swallowing is one of the classic symptoms of this syndrome, and it is usually caused by the strictures or webs that form in the esophagus. In Plummer-Vinson syndrome, the webs and strictures are generally present in the upper part of the esophagus. The majority of the swallowing difficulties associated with this syndrome tend to come and go in the early stages, and they are usually painless at that time. Painful swallowing starts as the esophageal webs grow in size. While swallowing troubles tend to occur only with solid foods, patients who do not have their swallowing issues addressed could go on to develop difficulties with swallowing liquids too.
Patients with swallowing troubles may experience unintentional weight loss that could lead to more serious health issues. When assessing swallowing problems, doctors will ask the patient about when these occur and whether they occur with specific foods. Patients may need to have x-rays, barium swallow tests, or other imaging studies to determine the severity of the issues and check for the presence of esophageal strictures or other abnormalities. Endoscopic dilation and argon plasma coagulation therapy may be recommended in cases of persistent swallowing trouble.
Atrophic Glossitis
Atrophic glossitis is a condition in which the patient experiences inflammation of the tongue. Also known as Hunter's glossitis, the atrophic form of the condition causes the loss of many papillae from the tongue. The color of the tongue may change, and it will often have a glossy appearance. The tongue will become very sore, and eating may be difficult. For patients with Plummer-Vinson syndrome, atrophic glossitis is normally a result of the iron deficiencies that are common with this disorder.
Doctors may prescribe topical corticosteroids to reduce the pain and redness that occurs with atrophic glossitis. Patients will need to avoid foods that could increase inflammation of the tongue, including spicy foods or other foods to which they have sensitivities. Tongue symptoms may resolve after iron levels normalize.
Weakness
Patients with Plummer-Vinson syndrome typically exhibit weakness, which may occur on exertion or at rest. The weakness seen with this syndrome is most often due to iron deficiency. Patients may notice they frequently feel tired, and lethargy is also common. Some individuals might experience shortness of breath after exertion, not necessarily just from physical exercise but also from daily activities. Since weakness can have many causes, patients should see a doctor if this symptom worsens or persists for longer than two weeks. To help in diagnosis, patients may wish to keep a journal noting the dates and times they have felt weak and what they were doing when the weakness or lethargy began.
Physicians will examine the patient to detect potential lung or heart problems that could cause weakness, and blood tests will also be needed to look for iron deficiencies and other abnormalities that may be contributing to feelings of weakness. In cases where this symptom is caused by low iron, patients may experience relief through treatment with oral iron supplements. During periods of weakness, patients should try to rest and avoid overexertion.
Angular Stomatitis
Also known as angular cheilitis, angular stomatitis is a condition in which patients develop swollen, red patches at the corners of the mouth, normally on the outside of the lips. The patches can form on either one or both sides of the mouth, and they may be crusty or scaly. While some patients only experience mild symptoms, others develop bleeding and blisters that are often very painful. Itching may also be present, and the patient might develop a bad taste in the mouth that could lead to eating difficulties.
When angular stomatitis occurs in patients with Plummer-Vinson syndrome, it is generally due to an iron deficiency. In addition to iron supplements, doctors will likely recommend the use of topical steroid ointments and topical antiseptics to treat angular stomatitis. Patients may find applying coconut oil or petroleum jelly at the corners of the mouth helps soothe the area, and these substances can also provide a protective barrier against saliva.
Burning Sensations
Patients with Plummer-Vinson syndrome might experience burning sensations across several areas of the body. The iron deficiency associated with this condition is known to cause burning sensations on the tongue, and some patients who are low in iron have reported tingling or burning sensations in their arms and legs. Burning sensations on the outer corners of the mouth may be present if the patient has angular cheilitis as a result of Plummer-Vinson syndrome.
Individuals with this syndrome who also have gastroesophageal reflux disease (GERD) may experience heartburn and a burning sensation in the mouth or throat, and these sensations may worsen if esophageal strictures develop. Depending on the area where the burning sensation occurs, patients may be able to experience relief from this sensation through iron supplementation, treatment for angular cheilitis, avoidance of spicy foods, and esophageal procedures to treat strictures.